Nursed to Health: Antibiotics can't help every infection

Antibiotics fight infections caused by bacteria. The first antibiotic, penicillin, was discovered in 1928. In the 1940s, widespread use of antibiotics revolutionized medicine and our ability to fight major bacterial infections. As a result, many lives were saved.

But in recent years, a new problem with bacterial infections has arisen: Antibiotics have been overprescribed for many years.

Patients want relief from their symptoms and illnesses. Health care practitioners want to help and satisfy their patients. So along the way, antibiotics have been prescribed when they shouldn’t have been.

The Centers for Disease Control and Prevention reports that nearly 7 of 10 patients with upper-respiratory infections were prescribed antibiotics. Of those prescriptions, 80 percent were given to patients with viral upper-respiratory infections that do not respond to treatment with antibiotics. This practice contributed to the development of serious drug-resistant infections or “super bugs” that cannot be cured with many antibiotics.

Antibiotics kill bacterial infections, but do not work on viral infections. Most upper-respiratory infections are caused by viruses. The CDC reports that we spend $1.1 billion each year on unnecessary antibiotics for adult viral respiratory infections.

The CDC also reports that more than 2 million illnesses and 23,000 deaths are reported each year related to antibiotic resistance. Antibiotics can also have serious side effects such as allergic reactions, drug interactions, heart arrhythmias and antibiotic-associated diarrhea.

JU’s nurse practitioner students in its School of Nursing often encounter pressure from patients who think they should be prescribed antibiotics for viral respiratory infections. If they do not receive an antibiotic, they may feel as though they wasted money and time seeking help. Patients also may incorrectly think that an antibiotic would prevent them from spreading the infection, and they may be concerned about the cost and time required to return for help if the symptoms do not resolve.

These expectations present a challenge for doctors, nurses and all health care practitioners. It is important to teach future nurse practitioners to educate their patients about appropriate antibiotic use.

Here is a composite case recently handled by JU nursing students that presents their typical patient encounters in primary care:

J.T.

A 23-year-old male, J.T. came to the nurse practitioner clinic complaining of a cough lasting more than a week. He stated he had not had a fever, sore throat, fatigue or any muscle aches. His cough was getting better, but he still experienced some episodes of dry coughing at night.

J.T. had three roommates who also came down with a cough. They were upset with J.T. and told him that if he had gone to the doctor for antibiotics when he first became ill, they would not have gotten his cold. He asked the nurse practitioner for a “Z-Pak” (brand name for azithromycin) antibiotic, saying he felt bad about getting his roommates sick and wanted to get over his illness quickly.

While J.T.’s roommates were correct in their assumption that they caught their cold from him, they were wrong that an early Z-Pak or other antibiotic would have prevented the spread.

J.T. was found to have a viral upper-respiratory infection, which antibiotics will not cure. They also will not prevent the spread of the infection to others and will not make the patient feel better faster. And, as said earlier, they may even have serious side effects.

Simple measures to prevent the spread of infection in this case include: covering the mouth when coughing; not sharing drinks or eating utensils; and good hand-washing.

J.T. was smart to seek medical care to make sure he did not have a more serious infection. The nurse practitioner student spent time making sure that J.T. understood why he did not need the Z-Pak and what he could do to feel better and prevent the spread of the infection.

The CDC Get Smart campaign is designed to help the public understand appropriate antibiotic use. This campaign also provides a wealth of information for nurse practitioners and other health care providers. You can get more information at www.cdc.gov/Features/GetSmart/.

Information for Nursed to Health is based on actual and composite cases of patients treated by students, alumni and faculty of Jacksonville University’s School of Nursing. Names and specific medical information have been changed to protect private health information, and any similarity is coincidental. For more information about JU’s School of Nursing, visit www.ju.edu/COHS. Readers with specific questions regarding their own health concerns should seek the advice of their health care provider.